Depression and systemic lupus erythematosus: a systematic review

Area of Science:

• Rheumatology
• Psychiatry
• Neuroscience

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple organ systems, including the central nervous system.
• Mood disorders, particularly depression, are recognized as a component of neuropsychiatric SLE.
• Understanding the clinical and psychobiological relationship between depression and SLE is crucial for patient care.

Purpose of the Study:

• To systematically review the existing literature on the clinical and psychobiological relationship between depression and Systemic Lupus Erythematosus (SLE).
• To synthesize findings regarding the prevalence, symptoms, and potential underlying factors of depression in SLE patients.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, EMBASE, PsychINFO).
• Keywords used included 'depression' and 'SLE', utilizing MeSH headings for comprehensive retrieval.

Main Results:

• Seventeen studies reported depression in SLE, with prevalence ranging from 17% to 75%.
• Common symptoms included fatigue, weakness, somatic disorders, and sleep disturbances; suicide ideation was elevated.
• The relationship between depression and SLE disease activity was contradictory across studies; psychosocial factors were frequently cited as a potential link.

Conclusions:

• Variability in assessment methods and significant methodological limitations hinder definitive conclusions on depression prevalence, type, and symptoms in SLE.
• The association between depression and SLE disease activity remains controversial.
• Developing evidence-based diagnostic guidelines and identifying SLE-specific depression biomarkers are high priorities.